| NPI | 1801574116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 10417) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2026001422) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 10054459) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209034555) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 87551) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MT APRN-285286) | |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2026-02-09 |